Medicare Glossary

The Must-Read Medicare Glossary

*Repost* http://www.aarp.org/health/medicare-insurance/info-2017/medicare-glossary-reference.html

A reference tool for some of the most commonly used Medicare terms

by Dena Bunis, AARP Bulletin, October 2017|Comments: 0

There are key terms you should know when researching Medicare options.

Medicare: The federal program that helps people over 65 and some people with disabilities pay for their health care. It is structured as an insurance program with several “parts.” Each covers a different type of cost.

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Part A: Covers hospital stays, selected costs of continuing care after a hospital stay, some home health services and hospice.

Part B: Covers doctor visits and services, preventive care, lab tests and screenings, medical equipment and supplies, and some home health care.

Part C: Allows private health insurance companies to provide Medicare benefits. Known as Medicare Advantage plans, they are often HMOs or PPOs offering comprehensive health coverage that includes the services covered by parts A and B and sometimes more. Most also cover prescription drugs (Part D).

Part D: Covers outpatient prescription drug costs.

Supplemental Insurance, also known as Medigap: This is optional private insurance that Medicare recipients can buy to pay for out-of-pocket expenses (such as coinsurance costs) that traditional Medicare doesn’t cover. 

Coinsurance: The percentage of the cost that you pay for a medical service or equipment. For example, for many Part B services, Medicare pays 80 percent of the cost; your coinsurance in those cases is 20 percent.

Copay: A specific dollar amount that you pay as your share of the cost of a medical service or equipment. For example, in a Medicare Advantage plan, you might have a $25 copay for a doctor visit; under Part D, you might have $10 copay for a particular prescription each time you get a refill.

Coverage gap: Also called the doughnut hole, this kicks in when you and your prescription drug plan costs reach a coverage limit that the government sets each year — $3,750 for 2018. After that, you pay a larger share of your prescription drug costs until your out-of-pocket costs reach a government-set threshold — $5,000 in 2018. After that, the government picks up most of the tab for your drugs. Under the Affordable Care Act, this coverage gap will be eliminated in 2020.

Deductible: The amount you must pay before insurance pays anything. For example, the Part B deductible in 2017 was $183; that means you must pay for the first $183 in expenses that fall under Part B before it will begin covering costs. 

Also of Interest

• READ: Medicare Resource Center
• WHERE AARP STANDS: AARP CEO: We'll fight for Medicare
• READ: Navigating the Medicare maze
• TELL US: What are your concerns about Medicare?

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Medicare 2017

Medicare 2017 costs at a glance

Repost by: 

Listed below are basic costs for people with Medicare. If you want to see and compare costs for specific health care plans, visit the Medicare Plan Finder.

For specific cost information (like whether you've met your deductible, how much you'll pay for an item or service you got, or the status of a claim), visit MyMedicare.gov. 

Find out if Medicare covers a specific test, item or service that's not listed under the detailed Medicare cost information section of this page.

2017 costs at a glance
Part A premium	Most people don't pay a monthly premium for Part A (sometimes called "premium-free Part A"). If you buy Part A, you'll pay up to $413 each month. Calculate my premium.
Part A hospital inpatient deductible and coinsurance	You pay:  $1,316 deductible for each benefit period Days 1-60: $0 coinsurance for each benefit period Days 61-90: $329 coinsurance per day of each benefit period Days 91 and beyond: $658 coinsurance per each "lifetime reserve day" after day 90 for each benefit period (up to 60 days over your lifetime) Beyond lifetime reserve days: all costs
Part B premium	The standard Part B premium amount is $134 (or higher depending on your income). However, most people who get Social Security benefits will pay less than this amount ($109 on average).
Part B deductible and coinsurance	$183 per year. After your deductible is met, you typically pay 20% of the Medicare-approved amountfor most doctor services (including most doctor services while you're a hospital inpatient), outpatient therapy, and durable medical equipment.
Part C premium	The Part C monthly premium varies by plan. Compare costs for specific Part C plans.
Part D premium	The Part D monthly premium varies by plan (higher-income consumers may pay more). Compare costs for specific Part D plans.

Detailed Medicare cost information for 2017

expand iconMedicare Part A (Hospital Insurance)

expand iconMedicare Part B (Medical Insurance)

expand iconMedicare Part C (Medicare Advantage)

expand iconMedicare Part D (Medicare prescription drug coverage)

Read More @: https://www.medicare.gov/your-medicare-costs/costs-at-a-glance/costs-at-glance.html

You’re 65 and Working: What about Medicare?

Repost: 
Medicare Tips & Resources | Tue, Jun 14, 2016 @ 09:00 AM

You’re 65 and Working: What about Medicare?

Posted by Medicare Made Clear: Retirement used to be closely linked to turning 65. No more. The full retirement age — when you can receive 100% of your social security retirement benefit — is 66 for anyone born in 1943. And, it’s 67 if you were born in 1960 or later.

However, Medicare eligibility still begins at age 65, even if retirement does not. People on disability could be eligible for Medicare before they turn 65.The question is: What do employed 65-year-olds do about Medicare

Medicare Before You Retire? Maybe

If you or your spouse is working, then you may have health insurance through an employer. It’s important to understand how Medicare may work with your existing insurance.

Before you do anything about Medicare, you need to talk with your employer health plan administrator. Questions you may want to ask include:

• What kind of health plan do I have? For example, many employer plans are HMOs (health maintenance organizations).
• Does my employer require that I enroll in Medicare?
• How would my health insurance change if I enrolled in Medicare?
• How much is deducted from each paycheck for health insurance? (Remember that you do not pay taxes on payroll deductions for health insurance. You need to consider the tax savings to determine the total value.)

This information may help you evaluate your Medicare choices and decide what’s best for you.

Enroll in Medicare Part A? Probably

Most people enroll in Medicare Part A (hospital coverage) when they turn 65, whether they are working or not. This is because Part A is premium-free for most people. You earn this benefit by paying into the Medicare program while you’re working. You qualify for premium-free Part A if you or your spouse contributed to Medicare for at least 10 years.

In general, hospital expenses are covered first by your employer health plan. Medicare Part A is the secondary payer. It’s a good idea to enroll in Part A as soon as you’re eligible, so you don’t have to worry about signing up later.

There may be reasons to delay Part A, such as if your employer health plan is a Health Savings Account (HSA)—employer contributions could stop if you have Medicare. It’s very important for you to learn how Medicare may change your employer health benefits.

Enroll in Medicare Part B? Depends

Medicare Part B (doctor and outpatient coverage) charges a premium. In 2016, the monthly premium starts at $121.80 per month for new enrollees. It may be more for people with higher incomes.

Many people who have employer coverage delay enrolling in Part B to postpone paying the premium. You can sign up later during a Special Enrollment Period without penalty.

Part B may be of limited value when you have other health insurance. Exceptions may be people who are self-employed or who work for an employer with less than 20 full-time employees, since Medicare would become the primary payer in these situations.

It’s very important to find out how Part B would work with your employer plan before making your decision.

Conclusion

You have a number of Medicare decisions to make when you become eligible for Medicare. This is especially true when you have other health insurance. You may want to start learning about your choices ahead of time. Preparation may help you avoid unnecessary costs.

Brought to you by UHC - Medicare Made Clear 

https://blog.medicaremadeclear.com/Youre-65-Working-What-Medicare/?utm_source=facebook&utm_medium=social&utm_campaign=post&utm_content=blog2016_kcR&WT.mc_id=880576

Medicare 101: What is Medicare Part A?

Medicare 101: What is Medicare Part A?

TransAmerica Page: Medicare 101: What is Medicare Part A?

Medicare can be confusing, but don’t worry. You aren’t the only one feeling that way. Although there are many benefits to Medicare, with its different components and enrollment periods, it can get a little confusing. In this three-part series, we’ll break down Parts A, B, C and D of Medicare down to their essentials. Here are simple answers to the most-asked questions about Part A:

What does Medicare Part A cover?

Medicare Part A combined with Part B, make up what is known as Original Medicare. Part A covers emergency care, hospital stays, some nursing home care, and other long-term visits such as home health services and hospice care.

Who qualifies?

• Seniors (age 65 and above) who are U.S. citizens and permanent residents.
• Individuals with qualified disabilities (age 64 and below).

When should I enroll?

You can enroll during your Initial Enrollment Period (IEP), which usually lasts 7 months:

• Three months before your 65th birthday or 25th disability check.
• Month of your 65th birthday or 25th disability check.
• Three months after your 65th birthday or 25th disability check.

If you miss your Initial Enrollment Period, you can sign up during the General Enrollment Period, which is from January 1 to March 31. If you sign up during this time, your coverage will start July 1. Please note that if you enroll during the General Enrollment Period you may have to pay a higher premium for late enrollment.

Fall Open Enrollment occurs every year between October 15th and December 7th and allows those who already have Medicare to change their coverage. We recommend you review your coverage every year, as this is the one time when all people with Medicare can make changes to their plans for the next year.

How much does it cost?

Part A plans are provided to you at no cost if you or your spouse have worked and paid taxes for at least 40 quarters (or 10 years).

If this isn’t the case, you will pay a monthly premium of up to $407. The exact amount you’ll pay is determined by different factors such as your income and assets.

If you’re concerned about the costs involved that aren’t covered by Medicare, Medicare Supplement Insurance can help cover expenses that you’ll have to pay out of pocket.

For more info, check out Medicare.gov and this chart published by the Transamerica Center for Health Studies®.

The Transamerica Center for Health Studies® (TCHS) is a division of the Transamerica Institute®, a nonprofit, private foundation. TI is funded by contributions from Transamerica Life Insurance Company and its affiliates and may receive funds from unaffiliated third parties. TCHS is dedicated to identifying, researching and analyzing the most relevant health care issues facing consumers and employers nationwide. For more information about TCHS, please visit www.TransamericaCenterforHealthStudies.org.

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